tricare physical therapy copay

Tricare Physical Therapy Copay - AKPT | 5 February 2021 | Back and Neck Pain, Insurance Update, Physical Therapy | 0 comments

TRICARE, one of the nation's largest insurers, wants its members to receive physical therapy for back pain. They think that PT treatment for back pain is so important that they are willing to waive the cost for their members. This is a great deal. When was the last time you remember an insurance company covering the entire cost of something?

Tricare Physical Therapy Copay

You probably already know that back pain is a common problem. What you may not know is that the medical system is not very good at dealing with it.

Insurance & Billing

This means that insurance companies and patients often spend a lot of money to get better results.

You probably won't go into surgery right away, so the specialist will send you to a PT or refer you back to your PCP so you can get a PT referral.

The path looks different for everyone, but the end result is often the same - multiple failed treatments, imaging you may not need, and weeks or months of delay in seeing a physical therapist.

A number of large studies have looked at the effects of early physical therapy on back pain, with impressive results.

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One of them was done in Seattle in 2006 by the Virginia Mason Medical Center. They partnered with Aetna and Starbucks to refer workers with back pain to both physical therapists and physicians for initial treatment. MRI use dropped by 1/3, people got better faster, had less work, and were more satisfied with their care. The cost savings were so great that Virginia Mason was losing money on back pain care, and Aetna was saving so much money that Aetna was paying more for PT treatments.

Intel ran a similar program with its employees, getting people with back pain into PT within 48 hours. People used to take about 19 days to enter PT. With earlier access, patients completed treatment in 21 days compared to the previous 52 days, and costs were reduced by 10-30%. Intel also reported greater satisfaction with care and a faster return to work.

Physical therapy has proven to be the cheapest and most effective treatment for back pain in many people.

It goes without saying that people with back pain should begin treatment with their physical therapist, but many do not. TRICARE's pilot program waives payment for up to three PT visits and aims to change that. If successful, it will reduce costs for TRICARE and their members and lead to better outcomes in the short term. Currently, Molina begins PT for musculoskeletal injuries before its members receive other types of treatment, such as pain injections. By following such a protocol, insurance companies allow early access to PTs to avoid long-term disability.

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With the success of TRICARE's initiative to promote PT to its members, there is a good opportunity for other insurance companies to launch their own programs, so that more people can choose PT over other treatments.

If you suffer from pain and are considering starting PT, call us now to find out how insurance can cover your PT treatment.

Don't delay recovery by worrying about costs. Take the first step towards pain relief.

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